Table 1.
Overview of clinical parameters of patients with normal and impaired fracture healing of the tibia
| All patients, n=80 | Normal healing, n=48 (60%) | Impaired healing, n=32 (40%) | P-value | |
|---|---|---|---|---|
| Age | 40 [24–55] | 37 [24–58] | 42 [25–54] | NS |
| Sex | 58% male | 54% male | 63% male | NS |
| Injury severity Score | 25 [19–34] | 25 [18–34] | 24 [19–33] | NS |
| New Injury severity Score | 27 [22–41] | 31 [22–34] | 27 [22–41] | NS |
| Number of fractures | 4 [2–5] | 3 [2–5] | 4 [2–6] | NS |
| Tibia-fracture localization | ||||
| – proximal | 20% | 20% | 19% | NS |
| – shaft | 49% | 48% | 52% | NS |
| – distal | 31% | 32% | 29% | NS |
| Type of tibia fracture (AO) | ||||
| – multifragmentary/complex | 37% | 32% | 45% | NS |
| – intra-articular | 31% | 32% | 29% | NS |
| Soft-tissue injury (Gustilo) | ||||
| – 0 closed fracture | 59% | 69% | 44% | 0.037 |
| – I wound <1 cm | 14% | 13% | 16% | NS |
| – II wound >1 cm with moderate soft tissue damage | 15% | 10% | 22% | NS |
| – III wound >1 cm with | ||||
| ➢IIIa adequate soft-tissue cover | 6% | 6% | 6% | NS |
| ➢IIIb inadequate soft-tissue cover | 5% | 2% | 9% | NS |
| ➢IIIc associated arterial injury | 1% | 0% | 3% | NS |
| Time until tibia fixation (days) | 0 [0–5] | 0 [0–5] | 1 [0–6] | NS |
| Type of fixation | ||||
| – nonoperative | 11% | 19% | 0% | 0.010 |
| – ORIF | 43% | 44% | 41% | NS |
| – nail (ETN, UTN, or CTN) | 44% | 38% | 53% | NS |
| – external | 3% | 0% | 6% | NS |
| Number of operations | 2 [1–4] | 2 [1–3] | 2 [1–5] | NS |
| ICU stay (days) | 0 [0–8] | 1 [0–9] | 0 [0–7] | NS |
| 5.1 (8.3) | 4.9 (7.5) | 5.4 (9.4) | ||
| Hospital stay (days) | 27 [14–50] | 27 [14–50] | 28 [12–46] | NS |
| Complications | 56% | 56% | 56% | NS |
| – infectious | 41% | 44% | 38% | NS |
| – sepsis | 9% | 8% | 9% | NS |
| – noninfectious | 31% | 27% | 38% | NS |
| Delayed union | 16% | – | 41% | – |
| Nonunion | 24% | – | 59% | – |
| – atrophic | – | – | 47% | – |
| – hypertrophic | – | – | 53% | – |
Note: Data shown as median ± [interquartile range] or mean ± (standard deviation).
Abbreviations: NS, not significant; AO, arbeitsgemeinschaft für Osteosynthesefragen (association for study of internal fixation); ORIF, open reduction internal fixation; ETN, expert tibial nail; UTN, unreamed tibial nail; CTN, cannulated tibial nail; ICU, intensive care unit.